CAPA Performing Arts Camp
March 11, 2017 at Churchill High School
Applications are due by February 23, 2017
( $25 cash or checks can be made out to: Churchill High School)
Student Name: ___________________________________ Grade: ______
Phone Contact name and number: _____________________________
E~mail address (please print legibly): _______________________________________
T-Shirt Size (adult sizes) : S M L XL XXL
Area of Interest for the day: (circle only one please) Acting Vocal Dancing
Why do you want to be a part of the CAPA Performance Arts Camp?
Any food allergies? If yes, please list the allergy:
- No student should be in the hallways or bathrooms without supervision.
- Mentors/adults will escort students to appropriate rooms (including bathroom breaks)
- Attendance will be taken in every session after breaks.
- CAPA will distribute snacks to rooms during break times and serve a pizza lunch to students. Students may also bring a bag lunch to the camp.
- In the event of an emergency, immediately find a CAPA staff member or volunteer (parents/guardians of the participants must be available by phone during the hours of the camp)
- Staff will stay with students until they are picked up at the end of the day, 3:00. A late fee of $5.00 will be charged for every 15 minutes after the designated pick up time of 3:00.
- Parent/Guardian must check their student in and out of the camp at the registration table before dropping off or picking up their student. Registration/check in begins at 8:30 a.m..
- Students will leave all valuables, including cell phones, at home. Phone service is available for students in case of emergency or to call home for a pick up.
- By signing below, both student and parent/guardian agree to the above workshop rules and verbal directions given by the camp staff.
Student Signature Date
Parent/Guardian Name Parent/Guardian Signature
Please send all 3 with a payment of $25 by February 23, 2017 to:
Ms. Hillman, Director of CAPA Forms:
Churchill High School 1. Registration ____
8900 Newburgh Road 2. Health and Emergency ___
Livonia MI 48150 3. T-shirt size & full workshop payment ____